From floods to hurricanes, bushfires to droughts, the effects of climate change are well and truly here — and they’re affecting almost every industry on earth. Big pharma is certainly no exception.
The COVID-19 pandemic already exposed fault lines in the world’s medicine supply system. Australia is still reeling from this impact, with hundreds of drugs currently unavailable. As extreme weather events and rising temperatures continue, the world can expect to see more strain placed on our pharmaceutical supply lines — as a dying planet makes people sicker than ever.
Heatwaves and hurricanes halt development
The world’s drug supply relies on an international network of farms and facilities and is often siloed, with active ingredients manufactured in one location before being processed in another country, packaged in a third and sold around the world.
It means disruption in one country can have a wide-ranging knock-on effect, Menzies Institute research fellow Professor Martin Hensher tells Crikey.
“Every country has experienced pharmaceutical supply chain issues to some extent because most of the active ingredients are made in only a handful of countries,” he says.
India and China manufacture between 60% and 80% of the world’s active pharmaceutical ingredients, and are two of the countries most threatened by climate change. The August heatwave in China — the hottest period in 60 years — caused rolling blackouts, with the government ordering factories to suspend operations to conserve energy (though it’s unclear if this has had an impact on the pharmaceutical industry).
Elsewhere, Puerto Rico manufactures a huge proportion of the US’ drugs and intravenous fluids. When the devastating Hurricane Maria hit in 2017 — the strongest storm in nearly 90 years — the country’s drug supply was heavily impacted, with common local anesthetics running dry. It’s estimated pharmaceutical giant Pfizer lost US$195 million in inventory after three facilities were destroyed in the country.
To address disruptions, countries would have to start developing pharmaceuticals themselves to reduce reliance on a single county, says Hensher.
“We’ve become used to globalised supply chains, which get us everything at very low cost from China,” he says. “Can we really continue with a couple of key countries as the manufacturers of everything for the whole world, when this kind of disruptive potential starts to grow?
“[To change] would mean a trade-off between resilience and efficiency. So if you want to secure supply, you are probably going to have to pay for it.”
Disruption starts at a local level
While COVID-19 exposed the international pharmaceutical supply chain’s vulnerabilities, climate change can have an immediate, local impact on access to medicines.
Australia’s 2019-20 bushfires saw thousands of people lose their homes and possessions, with many fleeing without their medication or prescriptions. The government responded by implementing emergency measures that allowed those affected to receive Pharmaceutical Benefits Scheme-subsidised medicine without a prescription.
It was a similarly desperate situation during this year’s Lismore floods, with local pharmacies and GP offices wiped out by the water levels. Some pharmacists resorted to using jet skis to deliver prescriptions. Last month, the Pharmaceutical Society of Australia, the Australian Medical Association and other health-sector leaders called for emergency funding to restock pharmacy shelves.
Elsewhere, humanitarian organisations have warned that flooding in Pakistan has meant millions can’t access routine life-saving drugs.
Natural drugs are also at risk
It’s not just manufactured medicines at risk. Medicinal plants are relied upon by up to 95% of people in developing nations, and as alternative or complementary treatments to modern medicines.
But habitat destruction, overdevelopment and a surge in demand have seen an increase in illegal and unsustainable harvesting of medicinal plants like American ginseng, commonly used for fatigue, upper respiratory infections and hypertension. Extinct herb silphium, once used in the ancient world, is considered by some to have been wiped out by over-farming and over-consumption, while drugs like coffee and some alcohol are today threatened. Sea sponges — called the “pharmacies of the sea” and used to develop antiviral drugs — are under threat from warmer ocean waters.
(There’s one medicine that may actually benefit from climate change: increasing levels of atmospheric carbon dioxide have doubled the potency of poppies, which is good news for Australia’s morphine market.)
Big pharma is partly to blame — and will benefit
Big pharma is one of the world’s biggest contributors to climate change — but will also benefit as more people become sick. One study estimated that in 2015 the industry produced 48.55 tonnes of carbon dioxide equivalent per million US dollars. In Australia, our health system produces around 7% of the nation’s C02 emissions, mostly through hospitals and health services. Pharmaceuticals account for 18% of those emissions.
While many companies are taking action, with a large number setting net-zero or carbon-neutral targets, it’s worth noting that climate change alters the health profile of a population, spurring big pharma to sell more drugs.
Air pollution and bushfires are leading to an increase in respiratory diseases, heatwaves will cause dehydration and death from overheating, while biodiversity loss (combined with increased travel) will lead to more infectious disease outbreaks. Climate change is already affecting vector-borne disease transmission and spread thanks to rising temperatures and rain (making mosquito-spread illnesses like malaria more common).
The changing landscape of disease, Hensher says, will be challenging.
“In areas of the country where previously you wouldn’t have contemplated treating those things, you’ll probably have a period when … people will be presenting and perhaps not being diagnosed correctly, initially,” he said.
“The issue then is needing drugs, diagnostic tests and vaccines where appropriate.”
Is Australia prepared for the strain climate change will put on access to medicine? Let us know your thoughts by writing to letters@crikey.com.au. Please include your full name to be considered for publication. We reserve the right to edit for length and clarity.
